Individual provider Active NPI

Sean David O Patry, DO

  • Emergency Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1417149592
Registry record updated Oct 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
INTERN TRAINING Issued in LA
Practice address
6451 Brentwood Stair Rd
Suite 200
Fort Worth, TX 76112-3200
Phone
(225) 358-3940
NPI assigned
Aug 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X INTERN TRAINING LA Primary
Emergency Medicine Physician 207P00000X N4631 TX

Addresses

Primary practice location

6451 Brentwood Stair Rd
Suite 200
Fort Worth, TX 76112-3200

Mailing address

3548 Hilltop Rd
Fort Worth, TX 76109-2812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100830000424 TX Practitioner - Emergency Medicine 4284709304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Arizona College of Osteopathic Medicine Mid Western University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Medicine Resources, LLPGroup PAC ID 5890688212, 255 clinicians

Practice addresses (Care Compare)

1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Phone (817) 250-2000

Hospital & facility affiliations

  • Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
INTERN TRAININGLAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Medicine Resources, LLP Emergency Medicine CurrentSince Apr 15, 2013 Accepting new patients
C & M Medical Services, Inc. Past Accepting new patients

Locations

1105 Central Expy N
Allen, TX 75013
Phone (972) 747-4313

201 Walls Dr
Cleburne, TX 76033
Phone (817) 556-5587

6451 Brentwood Stair Rd
Ste 200
Ft Worth, TX 76112
Phone (817) 496-9700

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1417149592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3548 HILLTOP RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761092812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6451 BRENTWOOD STAIR RD",
            "address_2": "SUITE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761123200",
            "telephone_number": "225-358-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O PATRY",
        "first_name": "SEAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-13",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "INTERN TRAINING",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "N4631",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.